Like the topic of infant feeding itself, public health bills can be a minefield. For each issue, there can be numerous pros, cons and opinions. And much like the debates that follow them, it is quite often that some go undiscussed by the mainstream media.
Many global health organisations state that babies should be breastfed exclusively for the first six months of their lives. But for some mums that is not possible, either for their own health or other personal reasons. These mothers instead turn to “first infant formula” – for babies up to six months old – to feed their children.
The problem is that though the NHS tells mothers that babies who are fed first infant formula need nothing more than that, there is still a wide range of “follow on” formulas available for babies over six months old. The health service has a clear stance that this variety is unnecessary, saying outright that there is “no evidence” that formulas marketed for “hungrier babies” make them sleep longer, for example.
So why do manufacturers make these products, and advertise their “health benefits” if children don’t need them? The current UK rules are that though follow-on formula milk can be promoted, manufacturers and sellers are banned from advertising “first infant formula”. Baby Milk Action, the UK member of the Intentional Baby Food Action Network (IBFAN), has highlighted that these adverts encourage brand recognition and cross-promote products, including infant formula intended for use by newborns.
The UK government does not proactively monitor formula advertising for breaches, so infant formula companies, who profit when women do not breastfeed, regularly undermine breastfeeding by breaching the code. Price promotions and prominent displays have been placed at the point of sale, and advertisements and promotions suggest that infant formula is comparable to breast milk in terms of health and development.
There are now moves to change this, however. The Feeding Products for Babies and Children (Advertising and Promotion) Bill passed through parliament on its first reading with unanimous support in November 2016 – though as yet it has not attracted the public attention that it should have.
If enacted, the bill would provide important provisions to protect the health of babies and children from corporate advertising, which the World Health Organisation identifies as a priority for improving child health. It would bring into UK law WHO provisions on the marketing of infant formula which have been in place since 1981. Though the country is signed up to the code, until this bill arrived the government had not fully legislated to implement it.
The WHO code includes a ban on the promotion of formula, including through advertising, gifts directed towards mothers and health professionals, and at the point of sale. It also provides detailed guidance on appropriate packaging, for example restricting nutritional and health claims and images which idealise formula use.
The follow-on fallacy
The Formula Marketing Bill has long been needed, and is of vital importance to ensuring the health of both babies and mothers. However, 26 years after the WHO code was signed by the UK, it has taken a private members’ bill to put this issue on parliament’s agenda – and even then its second reading has been delayed by a month already.
The provisions of the bill seek to establish a new infant and young child nutrition agency which would ensure that infant formula and packaging was regulated to optimise child health. This includes licensing feeding products suitable for children aged under 36 months, to prevent unnecessary ingredients being added, and to ensure that packaging does not undermine breastfeeding. Those who breach the law by selling unlicensed products could be fined or imprisoned for up to six months.
Other important clauses include one that would allow plain packaging of infant formula, and ban terms that can confuse parents, such as “follow-on milk”. These steps will help parents understand that the legally required recipe for infant formula results in minimal variation between brands, saving them money, and protecting them from unverifiable claims. Alongside this, the bill also seeks to comprehensively restrict other types of advertising and promotion of feeding products for babies and infants – for example, by restricting formula industry social media, parenting clubs and classes, and helplines.
We need to stop wasting time and make this bill law.